Titles II and XVI: Evaluation of Symptoms in Disability
Claims

PURPOSE:

We are rescinding
SSR 96-7p: Policy
Interpretation Ruling
Titles II and XVI Evaluation of Symptoms in Disability Claims:
Assessing the Credibility of an Individual's Statements and
replacing it with this Ruling. We solicited a study and
recommendations from the Administrative Conference of the United
States (ACUS) on the topic of symptom evaluation. Based on
ACUS's recommendations[1] and our adjudicative experience, we are
eliminating the use of the term “credibility” from
our sub-regulatory policy, as our regulations do not use this
term. In doing so, we clarify that subjective symptom evaluation
is not an examination of an individual's character. Instead, we
will more closely follow our regulatory language regarding
symptom evaluation.

Consistent with our regulations, we instruct our adjudicators
to consider all of the evidence in an individual's record when
they evaluate the intensity and persistence of symptoms after
they find that the individual has a medically determinable
impairment(s) that could reasonably be expected to produce those
symptoms. We evaluate the intensity and persistence of an
individual's symptoms so we can determine how symptoms limit
ability to perform work-related activities for an adult and how
symptoms limit ability to function independently, appropriately,
and effectively in an age-appropriate manner for a child with a
title XVI disability claim.

BACKGROUND:

In determining whether an individual is disabled, we consider
all of the individual's symptoms, including pain, and the extent
to which the symptoms can reasonably be accepted as consistent
with the objective medical and other evidence in the
individual's record. We define a symptom as the individual's own
description or statement of his or her physical or mental
impairment(s).[2] Under
our regulations, an individual's statements of symptoms alone
are not enough to establish the existence of a physical or
mental impairment or disability. However, if an individual
alleges impairment-related symptoms, we must evaluate those
symptoms using a two-step process set forth in our regulations.[3]

First, we must consider whether there is an underlying
medically determinable physical or mental impairment(s) that
could reasonably be expected to produce an individual's
symptoms, such as pain. Second, once an underlying physical or
mental impairment(s) that could reasonably be expected to
produce an individual's symptoms is established, we evaluate the
intensity and persistence of those symptoms to determine the
extent to which the symptoms limit an individual's ability to
perform work-related activities for an adult or to function
independently, appropriately, and effectively in an age-
appropriate manner for a child with a title XVI disability
claim.

This ruling clarifies how we consider:

The intensity, persistence, and functionally limiting
effects of symptoms,

The extent to which an individual's symptoms affect his
or her ability to perform work-related activities or
function independently, appropriately, and effectively in
an age-appropriate manner for a child with a title XVI
disability claim, and

Adjudication standards for evaluating symptoms in the
sequential evaluation process.

POLICY INTERPRETATION:

We use a two-step process for evaluating an individual's
symptoms.

The two-step process:

Step 1: We determine whether the individual has a medically
determinable impairment (MDI) that could reasonably be expected
to produce the individual's alleged symptoms

An individual's symptoms, such as pain, fatigue, shortness of
breath, weakness, nervousness, or periods of poor concentration
will not be found to affect the ability to perform work-related
activities for an adult or to function independently,
appropriately, and effectively in an age-appropriate manner for
a child with a title XVI disability claim unless medical signs
or laboratory findings show a medically determinable impairment
is present. Signs are anatomical, physiological, or
psychological abnormalities established by medically acceptable
clinical diagnostic techniques that can be observed apart from
an individual's symptoms.[4] Laboratory findings are anatomical,
physiological, or psychological phenomena, which can be shown by
the use of medically acceptable laboratory diagnostic
techniques.[5] We call
the medical evidence that provides signs or laboratory findings
objective medical evidence. We must have objective medical
evidence from an acceptable medical source[6] to establish the existence of a medically
determinable impairment that could reasonably be expected to
produce an individual's alleged symptoms.[7]

In determining whether there is an underlying medically
determinable impairment that could reasonably be expected to
produce an individual's symptoms, we do not consider whether the
severity of an individual's alleged symptoms is supported by the
objective medical evidence. For example, if an individual has a
medically determinable impairment established by a knee x-ray
showing mild degenerative changes and he or she alleges extreme
pain that limits his or her ability to stand and walk, we will
find that individual has a medically determinable impairment
that could reasonably be expected to produce the symptom of
pain. We will proceed to step two of the two-step process, even
though the level of pain an individual alleges may seem out of
proportion with the objective medical evidence.

In some instances, the objective medical evidence clearly
establishes that an individual's symptoms are due to a medically
determinable impairment. At other times, we may have
insufficient evidence to determine whether an individual has a
medically determinable impairment that could potentially account
for his or her alleged symptoms. In those instances, we develop
evidence regarding a potential medically determinable impairment
using a variety of means set forth in our regulations. For
example, we may obtain additional information from the
individual about the nature of his or her symptoms and their
effect on functioning. We may request additional information
from the individual about other testing or treatment he or she
may have undergone for the symptoms. We may request clarifying
information from an individual's medical sources, or we may send
an individual to a consultative examination that may include
diagnostic testing. We may use our agency experts to help us
determine whether an individual's medically determinable
impairment could reasonably be expected to produce his or her
symptoms. At the administrative law judge hearing level or the
Appeals Council level of the administrative review process, we
may ask for and consider evidence from a medical or
psychological expert to help us determine whether an
individual's medically determinable impairment could reasonably
be expected to produce his or her symptoms. If an individual
alleges symptoms, but the medical signs and laboratory findings
do not substantiate any medically determinable impairment
capable of producing the individual's alleged symptoms, we will
not evaluate the individual's symptoms at step two of our two-
step evaluation process.

We will not find an individual disabled based on alleged
symptoms alone. If there is no medically determinable
impairment, or if there is a medically determinable impairment,
but the impairment(s) could not reasonably be expected to
produce the individual's symptoms, we will not find those
symptoms affect the ability to perform work-related activities
for an adult or ability to function independently,
appropriately, and effectively in an age-appropriate manner for
a child with a title XVI disability claim.

Step 2: We evaluate the intensity and persistence of an
individual's symptoms such as pain and determine the extent to
which an individual's symptoms limit his or her ability to
perform work-related activities for an adult or to function
independently, appropriately, and effectively in an age-
appropriate manner for a child with a title XVI disability
claim.

Once the existence of a medically determinable impairment
that could reasonably be expected to produce pain or other
symptoms is established, we recognize that some individuals may
experience symptoms differently and may be limited by symptoms
to a greater or lesser extent than other individuals with the
same medical impairments, the same objective medical evidence,
and the same non-medical evidence. In considering the
intensity, persistence, and limiting effects of an individual's
symptoms, we examine the entire case record, including the
objective medical evidence; an individual's statements about the
intensity, persistence, and limiting effects of symptoms;
statements and other information provided by medical sources and
other persons; and any other relevant evidence in the
individual's case record.

We will not evaluate an individual's symptoms without making
every reasonable effort to obtain a complete medical history[8] unless the evidence
supports a finding that the individual is disabled. We will not
evaluate an individual's symptoms based solely on objective
medical evidence unless that objective medical evidence supports
a finding that the individual is disabled. We will evaluate an
individual's symptoms based on the evidence in an individual's
record as described below; however, not all of the types of
evidence described below will be available or relevant in every
case.

1. Consideration of Objective Medical Evidence

Symptoms cannot always be measured objectively through
clinical or laboratory diagnostic techniques. However,
objective medical evidence is a useful indicator to help make
reasonable conclusions about the intensity and persistence of
symptoms, including the effects those symptoms may have on the
ability to perform work-related activities for an adult or to
function independently, appropriately, and effectively in an
age-appropriate manner for a child with a title XVI claim.[9] We must consider
whether an individual's statements about the intensity,
persistence, and limiting effects of his or her symptoms are
consistent with the medical signs and laboratory findings of
record.

The intensity, persistence, and limiting effects of many
symptoms can be clinically observed and recorded in the medical
evidence. Examples such as reduced joint motion, muscle spasm,
sensory deficit, and motor disruption illustrate findings that
may result from, or be associated with, the symptom of pain.[10] These findings may be
consistent with an individual's statements about symptoms and
their functional effects. However, when the results of tests are
not consistent with other evidence in the record, they may be
less supportive of an individual's statements about pain or
other symptoms than test results and statements that are
consistent with other evidence in the record.

For example, an individual with reduced muscle strength
testing who indicates that for the last year pain has limited
his or her standing and walking to no more than a few minutes a
day would be expected to have some signs of muscle wasting as a
result. If no muscle wasting were present, we might not,
depending on the other evidence in the record, find the
individual's reduced muscle strength on clinical testing to be
consistent with the individual's alleged impairment-related
symptoms.

However, we will not disregard an individual's statements
about the intensity, persistence, and limiting effects of
symptoms solely because the objective medical evidence does not
substantiate the degree of impairment-related symptoms alleged
by the individual.[11] A
report of minimal or negative findings or inconsistencies in the
objective medical evidence is one of the many factors we must
consider in evaluating the intensity, persistence, and limiting
effects of an individual's symptoms.

2. Consideration of Other Evidence

If we cannot make a disability determination or decision that
is fully favorable based solely on objective medical evidence,
then we carefully consider other evidence in the record in
reaching a conclusion about the intensity, persistence, and
limiting effects of an individual's symptoms. Other evidence
that we will consider includes statements from the individual,
medical sources, and any other sources that might have
information about the individual's symptoms, including agency
personnel, as well as the factors set forth in our regulations.[12] For example, for a
child with a title XVI disability claim, we will consider
evidence submitted from educational agencies and personnel,
statements from parents and other relatives, and evidence
submitted by social welfare agencies, therapists, and other
practitioners.[13]

a. The Individual

An individual may make statements about the intensity,
persistence, and limiting effects of his or her symptoms. If a
child with a title XVI disability claim is unable to describe
his or her symptoms adequately, we will accept a description of
his or her symptoms from the person most familiar with the
child, such as a parent, another relative, or a guardian.[14] For an adult whose
impairment prevents him or her from describing symptoms
adequately, we may also consider a description of his or her
symptoms from a person who is familiar with the individual.

An individual may make statements about symptoms directly to
medical sources, other sources, or he or she may make them
directly to us. An individual may have made statements about
symptoms in connection with claims for other types of disability
benefits such as workers' compensation, benefits under programs
of the Department of Veterans Affairs, or private insurance
benefits.

An individual's statements may address the frequency and
duration of the symptoms, the location of the symptoms, and the
impact of the symptoms on the ability to perform daily living
activities. An individual's statements may also include
activities that precipitate or aggravate the symptoms,
medications and treatments used, and other methods used to
alleviate the symptoms. We will consider an individual's
statements about the intensity, persistence, and limiting
effects of symptoms, and we will evaluate whether the statements
are consistent with objective medical evidence and the other
evidence.

b. Medical Sources

Medical sources may offer diagnoses, prognoses, and opinions
as well as statements and medical reports about an individual's
history, treatment, responses to treatment, prior work record,
efforts to work, daily activities, and other information
concerning the intensity, persistence, and limiting effects of
an individual's symptoms.

Important information about symptoms recorded by medical
sources and reported in the medical evidence may include, but is
not limited to, the following:

Onset, description of the character and location of the
symptoms, precipitating and aggravating factors, frequency
and duration, change over a period of time (e.g., whether
worsening, improving, or static), and daily activities.
Very often, the individual has provided this information to
the medical source, and the information may be compared
with the individual's other statements in the case record.
In addition, the evidence provided by a medical source may
contain medical opinions about the individual's symptoms
and their effects. Our adjudicators will weigh such
opinions by applying the factors in
20 CFR 404.1527
and 416.927.

A longitudinal record of any treatment and its success
or failure, including any side effects of medication.

Indications of other impairments, such as potential
mental impairments, that could account for an individual's
allegations.

Medical evidence from medical sources that have not treated
or examined the individual is also important in the
adjudicator's evaluation of an individual's statements about
pain or other symptoms. For example, State agency medical and
psychological consultants and other program physicians and
psychologists may offer findings about the existence and
severity of an individual's symptoms. We will consider these
findings in evaluating the intensity, persistence, and limiting
effects of the individual's symptoms. Adjudicators at the
hearing level or at the Appeals Council level must consider the
findings from these medical sources even though they are not
bound by them. [15]

c. Non-Medical Sources

Other sources may provide information from which we may draw
inferences and conclusions about an individual's statements that
would be helpful to us in assessing the intensity, persistence,
and limiting effects of symptoms. Examples of such sources
include public and private agencies, other practitioners,
educational personnel, non-medical sources such as family and
friends, and agency personnel. We will consider any statements
in the record noted by agency personnel who previously
interviewed the individual, whether in person or by telephone.
The adjudicator will consider any personal observations of the
individual in terms of how consistent those observations are
with the individual's statements about his or her symptoms as
well as with all of the evidence in the file.

d. Factors to Consider in Evaluating the Intensity,
Persistence, and Limiting Effects of an Individual's
Symptoms

In addition to using all of the evidence to evaluate the
intensity, persistence, and limiting effects of an individual's
symptoms, we will also use the factors set forth in
20 CFR
404.1529(c)(3) and
416.929(c)(3).
These factors include:

Daily activities;

The location, duration, frequency, and intensity of
pain or other symptoms;

Factors that precipitate and aggravate the symptoms;

The type, dosage, effectiveness, and side effects of any
medication an individual takes or has taken to alleviate
pain or other symptoms;

Treatment, other than medication, an individual receives
or has received for relief of pain or other symptoms;

Any measures other than treatment an individual uses or
has used to relieve pain or other symptoms (e.g., lying
flat on his or her back, standing for 15 to 20 minutes
every hour, or sleeping on a board); and

Any other factors concerning an individual's functional
limitations and restrictions due to pain or other
symptoms.

We will consider other evidence to evaluate only the factors
that are relevant to assessing the intensity, persistence, and
limiting effects of the individual's symptoms. If there is no
information in the evidence of record regarding one of the
factors, we will not discuss that specific factor in the
determination or decision because it is not relevant to the
case. We will discuss the factors pertinent to the evidence of
record.

How we will determine if an individual's symptoms affect
the ability to perform work-related activities for an adult,
or age-appropriate activities for a child with a title XVI
disability claim

If an individual's statements about the intensity,
persistence, and limiting effects of symptoms are consistent
with the objective medical evidence and the other evidence of
record, we will determine that the individual's symptoms are
more likely to reduce his or her capacities to perform work-
related activities for an adult or reduce a child's ability to
function independently, appropriately, and effectively in an
age-appropriate manner for a child with a title XVI disability
claim.[16] In contrast,
if an individual's statements about the intensity, persistence,
and limiting effects of symptoms are inconsistent with the
objective medical evidence and the other evidence, we will
determine that the individual's symptoms are less likely to
reduce his or her capacities to perform work-related activities
or abilities to function independently, appropriately, and
effectively in an age-appropriate manner.

We may or may not find an individual's symptoms and related
limitations consistent with the evidence in his or her record.
We will explain which of an individual's symptoms we found
consistent or inconsistent with the evidence in his or her
record and how our evaluation of the individual's symptoms led
to our conclusions. We will evaluate an individual's symptoms
considering all the evidence in his or her record.

In determining whether an individual's symptoms will reduce
his or her corresponding capacities to perform work-related
activities or abilities to function independently,
appropriately, and effectively in an age-appropriate manner, we
will consider the consistency of the individual's own
statements. To do so, we will compare statements an individual
makes in connection with the individual's claim for disability
benefits with any existing statements the individual made under
other circumstances.

We will consider statements an individual made to us at each
prior step of the administrative review process, as well as
statements the individual made in any subsequent or prior
disability claims under titles II and XVI. If an individual's
various statements about the intensity, persistence, and
limiting effects of symptoms are consistent with one another and
consistent with the objective medical evidence and other
evidence in the record, we will determine that an individual's
symptoms are more likely to reduce his or her capacities for
work-related activities or reduce the abilities to function
independently, appropriately, and effectively in an age-
appropriate manner. However, inconsistencies in an individual's
statements made at varying times does not necessarily mean they
are inaccurate. Symptoms may vary in their intensity,
persistence, and functional effects, or may worsen or improve
with time. This may explain why an individual's statements vary
when describing the intensity, persistence, or functional
effects of symptoms.

We will consider an individual's attempts to seek medical
treatment for symptoms and to follow treatment once it is
prescribed when evaluating whether symptom intensity and
persistence affect the ability to perform work-related
activities for an adult or the ability to function
independently, appropriately, and effectively in an age-
appropriate manner for a child with a title XVI disability
claim. Persistent attempts to obtain relief of symptoms, such as
increasing dosages and changing medications, trying a variety of
treatments, referrals to specialists, or changing treatment
sources may be an indication that an individual's symptoms are a
source of distress and may show that they are intense and
persistent.[17]

In contrast, if the frequency or extent of the treatment
sought by an individual is not comparable with the degree of the
individual's subjective complaints, or if the individual fails
to follow prescribed treatment that might improve symptoms, we
may find the alleged intensity and persistence of an
individual's symptoms are inconsistent with the overall evidence
of record. We will not find an individual's symptoms
inconsistent with the evidence in the record on this basis
without considering possible reasons he or she may not comply
with treatment or seek treatment consistent with the degree of
his or her complaints. We may need to contact the individual
regarding the lack of treatment or, at an administrative
proceeding, ask why he or she has not complied with or sought
treatment in a manner consistent with his or her complaints.
When we consider the individual's treatment history, we may
consider (but are not limited to) one or more of the
following:

An individual may have structured his or her
activities to minimize symptoms to a tolerable level by
avoiding physical activities or mental stressors that
aggravate his or her symptoms.

An individual may receive periodic treatment or
evaluation for refills of medications because his or her
symptoms have reached a plateau.

An individual may not agree to take prescription
medications because the side effects are less tolerable
than the symptoms.

An individual may not be able to afford treatment and
may not have access to free or low-cost medical
services.

A medical source may have advised the individual that
there is no further effective treatment to prescribe or
recommend that would benefit the individual.

An individual's symptoms may not be severe enough to
prompt him or her to seek treatment, or the symptoms may
be relieved with over the counter medications.

An individual's religious beliefs may prohibit
prescribed treatment.

Due to various limitations (such as language or mental
limitations), an individual may not understand the
appropriate treatment for or the need for consistent
treatment of his or her impairment.

Due to a mental impairment (for example, individuals
with mental impairments that affect judgment, reality
testing, or orientation), an individual may not be aware
that he or she has a disorder that requires
treatment.

A child may disregard the level and frequency of
treatment needed to maintain or improve functioning
because it interferes with his or her participation in
activities typical of other children his or her age
without impairments.

The above examples illustrate possible reasons an individual
may not have pursued treatment. However, we will consider and
address reasons for not pursuing treatment that are pertinent to
an individual's case. We will review the case record to
determine whether there are explanations for inconsistencies in
the individual's statements about symptoms and their effects,
and whether the evidence of record supports any of the
individual's statements at the time he or she made them. We will
explain how we considered the individual's reasons in our
evaluation of the individual's symptoms.

Adjudication - How we will use our evaluation of
symptoms in our five-step sequential evaluation process to determine
whether an individual is disabled

In evaluating an individual's symptoms, it is not sufficient
for our adjudicators to make a single, conclusory statement that
"the individual's statements about his or her symptoms have been
considered" or that "the statements about the individual's
symptoms are (or are not) supported or consistent." It is also
not enough for our adjudicators simply to recite the factors
described in the regulations for evaluating symptoms. The
determination or decision must contain specific reasons for the
weight given to the individual's symptoms, be consistent with
and supported by the evidence, and be clearly articulated so the
individual and any subsequent reviewer can assess how the
adjudicator evaluated the individual's symptoms.

Our adjudicators must base their findings solely on the
evidence in the case record, including any testimony from the
individual or other witnesses at a hearing before an
administrative law judge or hearing officer. The subjective
statements of the individual and witnesses obtained at a hearing
should directly relate to symptoms the individual alleged. Our
adjudicators are prohibited from soliciting additional non-
medical evidence outside of the record on their own, except as
set forth in our regulations and policies.

Adjudicators must limit their evaluation to the individual's
statements about his or her symptoms and the evidence in the
record that is relevant to the individual's impairments. In
evaluating an individual's symptoms, our adjudicators will not
assess an individual's overall character or truthfulness in the
manner typically used during an adversarial court litigation.
The focus of the evaluation of an individual's symptoms should
not be to determine whether he or she is a truthful person.
Rather, our adjudicators will focus on whether the evidence
establishes a medically determinable impairment that could
reasonably be expected to produce the individual's symptoms and
given the adjudicator's evaluation of the individual's symptoms,
whether the intensity and persistence of the symptoms limit the
individual's ability to perform work-related activities or, for
a child with a title XVI disability claim, limit the child's
ability to function independently, appropriately, and
effectively in an age-appropriate manner.

In determining whether an individual is disabled or continues
to be disabled, our adjudicators follow a sequential evaluation
process.[18] The first
step of our five-step sequential evaluation process considers
whether an individual is performing substantial gainful
activity. If the individual is performing substantial gainful
activity, we find him or her not disabled. If the individual is
not performing substantial gainful activity, we proceed to step
2. We do not consider symptoms at the first step of the
sequential evaluation process.

At step 2 of the sequential evaluation process, we determine
whether an individual has a severe medically determinable
physical or mental impairment or combination of impairments that
has lasted or can be expected to last for a continuous period of
at least 12 months or end in death.[19] A severe impairment is one that affects
an individual's ability to perform basic work-related activities
for an adult or that causes more than minimal functional
limitations for a child with a title XVI disability claim.[20] At this step, we will
consider an individual's symptoms and functional limitations to
determine whether his or her impairment(s) is severe unless the
objective medical evidence alone establishes a severe medically
determinable impairment or combination of impairments that meets
our duration requirement.[21] If an individual does not have a severe
medically determinable impairment that meets our duration
requirement, we will find the individual not disabled at step 2.
If the individual has a severe medically determinable impairment
that has met or is expected to meet our duration requirement, we
proceed to the next step.

At step 3 of the sequential evaluation process, we determine
whether an individual's impairment(s) meets or medically equals
the severity requirements of a listed impairment. To decide
whether the impairment meets the level of severity described in
a listed impairment, we will consider an individual's symptoms
when a symptom(s) is one of the criteria in a listing to ensure
the symptom is present in combination with the other criteria.
If the symptom is not one of the criteria in a listing, we will
not evaluate an individual's symptoms at this step as long as
all other findings required by the specific listing are present.
Unless the listing states otherwise, it is not necessary to
provide information about the intensity, persistence, or
limiting effects of a symptom as long as all other findings
required by the specific listing are present.[22] In considering whether an
individual's symptoms, signs, and laboratory findings are
medically equal to the symptoms, signs, and laboratory findings
of a listed impairment, we will look to see whether the
symptoms, signs, and laboratory findings are at least equal in
severity to the listed criteria. However, we will not
substitute the individual's allegations of pain or other
symptoms for a missing or deficient sign or laboratory finding
to raise the severity of the impairment(s) to that of a listed
impairment.[23] If an
individual's impairment meets or medically equals the severity
requirements of a listing, we find him or her disabled. If an
individual's impairment does not meet or medically equal a
listing, we proceed to assess the individual's residual
functional capacity at step 4 of the sequential evaluation
process unless the individual is a child with a title XVI
disability claim.

For a child with a title XVI disability claim whose
impairment does not meet or medically equal the severity
requirements of a listing, we consider whether his or her
impairment functionally equals the listings. This means that
the impairment results in “marked” limitations in
two out of six domains of functioning or an
“extreme” limitation in one of the six domains.[24] We will evaluate an
individual's symptoms at this step when we rate how a child's
impairment-related symptoms affect his or her ability to
function independently, appropriately, and effectively in an
age-appropriate manner in each functional domain. If a child's
impairment functionally equals a listing, we find him or her
disabled. If a child's impairment does not functionally equal
the listings, we find him or her not disabled. For a child with
a title XVI disability claim, the sequential evaluation process
ends at this step.

If the individual's impairment does not meet or equal a
listing, we will assess and make a finding about an individual's
residual functional capacity based on all the relevant medical
and other evidence in the individual's case record. An
individual's residual functional capacity is the most the
individual can still do despite his or her impairment-related
limitations. We consider the individual's symptoms when
determining his or her residual functional capacity and the
extent to which the individual's impairment-related symptoms are
consistent with the evidence in the record.[25]

After establishing the residual functional capacity, we
determine whether an individual is able to do any past relevant
work. At step 4, we compare the individual's residual
functional capacity with the requirements of his or her past
relevant work. If the individual's residual functional capacity
is consistent with the demands of any of his or her past
relevant work, either as the individual performed it or as the
occupation is generally performed in the national economy, then
we will find the individual not disabled. If none of the
individual's past relevant work is within his or her residual
functional capacity, we proceed to step 5 of the sequential
evaluation process.

At step 5 of the sequential evaluation process, we determine
whether the individual is able to adjust to other work that
exists in significant numbers in the national economy. We
consider the same residual functional capacity, together with
the individual's age, education, and past work experience. If
the individual is able to adjust to other work that exists in
significant numbers in the national economy, we will find him or
her not disabled. If the individual cannot adjust to other work
that exists in significant numbers in the national economy, we
find him or her disabled. At step 5 of the sequential
evaluation process, we will not consider an individual's
symptoms any further because we considered the individual's
symptoms when we determined the individual's residual functional
capacity.

EFFECTIVE DATE: This SSR is effective on March 28, 2016

CROSS-REFERENCES:SSR 96-3p,
“Titles II and XVI:
Considering Allegations of Pain and Other Symptoms in
Determining Whether a Medically Determinable Impairment is
Severe,”
SSR 96-8p,
“Titles II and XVI: Assessing Residual
Functional Capacity in Initial Claims,”
SSR 96-6p,
“Titles II and XVI: Consideration of Administrative Findings of
Fact by State Agency Medical and Psychological Consultants and Other
Program Physicians and Psychologists at the Administrative Law
Judge and Appeals Council Levels of Administrative Review;
Medical Equivalence;” and Program Operations Manual System,
sections DI 24515.061
and DI 24515.064.

[1]
ACUS made several recommendations in its
March 12, 2015 final report, “Evaluating Subjective
Symptoms in Disability Claims.” Among other things, ACUS
recommended we consider amending
SSR 96-7p to clarify that
subjective symptom evaluation is not an examination of an
individual's character, but rather is an evidence-based analysis
of the administrative record to determine whether the nature,
intensity, frequency, or severity of an individual's symptoms
impact his or her ability to work. In any revised SSR, ACUS
also recommended we more closely follow our regulatory language
about symptom evaluation, which does not use the term
“credibility” and instead directs adjudicators to
consider medical and other evidence to evaluate the intensity
and persistence of symptoms to determine how the individual's
symptoms limit capacity for work if he or she is an adult, or
for a child with a title XVI disability claim, how symptoms
limit ability to function. ACUS further recommended when revising
SSR 96-7p, we
offer additional guidance to adjudicators
on regulatory implementation problems that have been identified
since we published
SSR 96-7p.

[8]
By “complete medical history,”
we mean the individual's complete medical history for at least
the 12 months preceding the month in which he or she filed an
application, unless there is a reason to believe that
development of an earlier period is necessary or the individual
says that his or her alleged disability began less than 12
months before he or she filed an application.
20 CFR 404.1512(d) and
416.912(d).